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    <td colspan="2" valign="top"><p><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;     C&#7896;NG H&Ograve;A X&Atilde; H&#7896;I CH&#7910; NGH&#296;A VI&#7878;T NAM&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>M&#7851;u s&#7889; 16/&#272;K</strong><strong> </strong></p></td>
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    <td align="center" valign="top"><strong>&#272;&#7897;c l&#7853;p - T&#7921; do - H&#7841;nh ph&uacute;c</strong><br>
      --------------------<br>
      <strong>ĐƠN XIN ĐĂNG KÝ THỪA KẾ QUYỀN SỬ DỤNG  ĐẤT
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    <p align="center"><span class="style3"><strong>K&iacute;nh g&#7917;i: </strong>............................................................</span></p></td>
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        <td bgcolor="#FFFFFF"><span class="style1">PH&#7846;N GHI C&#7910;A    NG&#431;&#7900;I NH&#7852;N H&#7890; S&#416;</span><br>
            <span class="style2"><strong>V&agrave;o s&#7893; ti&#7871;p    nh&#7853;n h&#7891; s&#417;:</strong><br>
              <em>......Gi&#7901;......ph&uacute;t,    ng&agrave;y......./......./.......</em><br>
              <em>Quy&#7875;n    s&#7889;........., S&#7889; th&#7913; t&#7921;................</em><br>
             <center> <strong>Ng&#432;&#7901;i nh&#7853;n h&#7891; s&#417;</strong><br>
            <em>(K&yacute; v&agrave; ghi r&otilde; h&#7885; t&ecirc;n)<br>
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        <strong>I. KÊ KHAI NHẬN THỪA KẾ QUYỀN SỬ DỤNG ĐẤT </strong><strong> </strong><br>
    (<em>Xem h&#432;&#7899;ng d&#7851;n cu&#7889;i &#273;&#417;n n&agrave;y tr&#432;&#7899;c khi k&ecirc;    khai; kh&ocirc;ng t&#7849;y xo&aacute;, s&#7917;a ch&#7919;a n&#7897;i dung &#273;&atilde; vi&#7871;t)</em></td>
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    <td width="686" colspan="2" valign="top" bgcolor="#FFFFFF"><p><strong>1. Ng&#432;&#7901;i s&#7917;    dung &#273;&#7845;t:</strong><br>
      1.1. T&ecirc;n ng&#432;&#7901;i s&#7917; d&#7909;ng &#273;&#7845;t: #HO_TEN# <em>(Vi&#7871;t ch&#7919; in    hoa)</em><br>
    1.2. &#272;&#7883;a ch&#7881;: #DIA_CHI# </p></td>
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    <td colspan="2" valign="top" bgcolor="#FFFFFF"><strong>2. Người để thừa kế quyền sử dụng đất:</strong>      <br>
      2.1. Tên người sử dụng đất: #NGUOI_DE_LAI# (Viết chữ in hoa).<br>
    2.2. Địa chỉ: #DC_NGUOI_DE_LAI#</td>
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    <td width="686" colspan="2" valign="top" bgcolor="#FFFFFF"><p><strong>3. </strong><br>
      3.1. Th&#7917;a &#273;&#7845;t s&#7889;: #THUA_DAT_SO# ;    3.2. T&#7901; b&#7843;n &#273;&#7891; s&#7889;: #BAN_DO_SO#;<br>
      3.3. &#272;&#7883;a ch&#7881; t&#7841;i: #DIA_CHI_DAT#.<br>
      3.4. Di&#7879;n t&iacute;ch th&#7917;a &#273;&#7845;t: #DIEN_TICH#m&sup2;; 
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            <td width="28%">3.5. M&#7909;c &#273;&iacute;ch s&#7917; d&#7909;ng    &#273;&#7845;t:</td>
            <td width="72%">#MUC_DICH_DAT#</td>
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          3.6. Th&#7901;i h&#7841;n s&#7917; d&#7909;ng &#273;&#7845;t: #THOI_HAN#;<br>
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              <td width="28%" valign="top">3.7. Nguồn gốc s&#7917; d&#7909;ng    &#273;&#7845;t:</td>
              <td width="72%">#NGUON_GOC#</td>
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                    3.8. T&agrave;i s&#7843;n g&#7855;n li&#7873;n v&#7899;i &#273;&#7845;t: #TAI_SAI#<br>
                    3.9. Nghĩa vụ tài chính về đất đai: #NGHIA_VU#<br>
          3.10. Gi&#7845;y ch&#7913;ng nh&#7853;n quy&#7873;n    s&#7917; d&#7909;ng &#273;&#7845;t:<br>&nbsp;&nbsp;&nbsp;&nbsp;
-      S&#7889; ph&aacute;t h&agrave;nh: #SO_PHAT_HANH#<em> (S&#7889; in &#7903; trang 1 c&#7911;a gi&#7845;y ch&#7913;ng nh&#7853;n quy&#7873;n s&#7917; d&#7909;ng    &#273;&#7845;t)</em><br>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;- 
S&#7889; v&agrave;o s&#7893; c&#7845;p GCN quy&#7873;n s&#7917; d&#7909;ng &#273;&#7845;t: #SO_VAO_SO#, ng&agrave;y c&#7845;p #NGAY_CAP#
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    <td width="686" colspan="2" valign="top" bgcolor="#FFFFFF"><p><strong>4. Gi&#7845;y t&#7901;    n&#7897;p k&egrave;m theo &#273;&#417;n n&agrave;y g&#7891;m c&oacute;</strong>:</p>
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            <td width="3%">&nbsp;</td>
            <td width="97%">#KEM_THEO#<br>
              * Giấy tờ khác: <br>
            #KHAC#</td>
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        Tôi  xin cam đoan nội dung kê khai trên đơn là đúng và thực hiện đầy đủ nghĩa vụ của  người để thừa kế trong <br>
việc sử dụng thửa đất mà tôi được nhận thừa kế.<br>
<em>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Vũng Tàu,  #NGAY# </em><br>
<strong><em>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </em>Ng&#432;&#7901;i vi&#7871;t &#273;&#417;n</strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <br>
<em>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<strong><em>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</em></strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </em>(<em>K&yacute;,  ghi r&otilde; h&#7885; t&ecirc;n)</em></td>
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    <td colspan="2" align="center" valign="top" bgcolor="#FFFFFF"><p><strong>II. K&#7870;T QU&#7842;    TH&#7848;M TRA C&#7910;A V&#258;N PH&Ograve;NG &#272;&#258;NG K&Yacute; QUY&#7872;N S&#7916; D&#7908;NG &#272;&#7844;T</strong></p></td>
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    <td colspan="2" valign="top" bgcolor="#FFFFFF">#THAM_DINH#<br></td>
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    <td width="326" valign="top" bgcolor="#FFFFFF" align="center"><em>Ng&agrave;y......th&aacute;ng.......n&#259;m........</em><br>
      <strong>Cán bộ địa chính</strong><br>
    <em> (K&yacute;, ghi r&otilde; t&ecirc;n)&nbsp;</em></td>
    <td width="321" valign="top" bgcolor="#FFFFFF" align="center"><p><em>Ng&agrave;y......th&aacute;ng.......n&#259;m........</em><br>
      <strong>TM.  Uỷ ban nhân dân<br>
    Chủ tịch<br>
</strong><em>(K&yacute; t&ecirc;n, &#273;&oacute;ng d&#7845;u)&nbsp;&nbsp; </em><br>
            <strong> </strong><br>
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